April 10, 2023
The Honorable Terri Sewell
The Honorable Brian Fitzpatrick
Dear Representatives Sewell and Fitzpatrick:
On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) is pleased to support your legislation, the Resident Physician Shortage Reduction Act of 2023 (H.R. 2389). Your bipartisan bill would increase by 14,000 the number of Medicare-funded residency positions, thereby helping to alleviate the physician shortages that threaten patients’ access to quality care.
In creating the graduate medical education (GME) program, Congress acted to ensure an adequate supply of well-trained physicians. However, the cap on residency slots established in the Balanced Budget Act restricts the number of residency slots for which hospitals may receive direct GME funding. The cap also limits the number of residents that hospitals may include in their ratios of residents-to-beds, which affects indirect medical education (IME) payments to teaching hospitals.
Thanks to your leadership, Congress provided 1,000 new Medicare-supported GME positions at the end of 2020 and 200 additional positions in 2022 – the first increases of their kind in more than 25 years. Your legislation would build on Congress’ historic investment by increasing the number of Medicare-supported residency positions by 2,000 each year for seven years, for a total of 14,000 new slots. A portion of these positions would be targeted for hospitals already training over their caps, hospitals in rural areas, hospitals in states with new medical schools or branch campuses, and hospitals serving areas designated as health professional shortage areas.
Your legislation responsibly addresses the nation’s urgent need for additional physicians. We also applaud you for directing the Government Accountability Office to recommend to Congress strategies for increasing the diversity of the health professional workforce.
We thank you for your strong leadership, and we stand ready to work with you to ensure enactment of this important legislation.
Executive Vice President